Gross Motor Delay

Cat 1 · 30 days

appointment within 30 calendar days. Very Severe Motor Skill Delay - A concurrent referral to Paediatric Medicine at GCUH must also occur [https://www.goldcoast.health.qld.gov.au/referrals/services/paediatric-medicine-general-paediatrics] - Significant developmental delay in an infant < 12 months of age - Infant < 12 months with concerns around quality of movement patterns which impact on functional daily activities such as nappy changing, handling by carers - Gradual regression or not progressing in motor skills Examples: - 4 months: Baby who has poor head control and is unable to lift their head up in prone or place and put weight through their forearms - 8 months: Baby who is not yet rolling. - 12 months: - Child who is only able to roll for mobility. - Child who is unable to sit.

Cat 2 · 90 days

appointment within 90 calendar days. Severe Motor Skill Delay - Child with developmental delays associated with abnormalities in neurological examination (may be referred to General Paediatrics initially) - Marked low tone or high tone - Muscle weakness / floppy child - Differences between right / left side of body in strength movement or tone - Microcephaly or increasing head circumference - Children over 18 months of age who are not walking independently - Gross motor delays in children under 18 months of age - Asymmetrical toe walking or asymmetrical in-toeing - Child with pain impacting on development of gross motor skills that has been reviewed by their GP prior to referral (hypermobility) Examples: - 6 months: - Infant not holding head and shoulders up with good control when lying on their tummy - Infant unable to hold head in the midline in supine or brings hands together in the midline - Infant not holding head with control in supported sitting - When supported in standing – persistent weight-bearing on toes - 9 months: - Infant is not sitting independently, not taking weight on legs when held in standing - 12 months: - Child sitting independently but cannot move out of sitting - Child not pulling to stand or holding on for support - Child has no form of independent mobility (e.g. crawling, commando crawling) - 18 months: - Child not walking - Child not standing independently - 2-year-old: - Child not walking independently

Cat 3 · 365 days

appointment within 365 calendar days. Moderate Motor Skill Delay (recommended to be seen within 90 to 180 calendar days) - Developmental delay with related medical co-morbidities - Motor delay: 18 months – 2 years (walking commenced at time of referral) - In-toeing causing tripping that is not asymmetrical (less than 3 years of age) Examples: - 2-year-old: - Child walking independently but unable to squat - Child with poor balance when walking. Mild - Moderate Motor Skill Delay (recommended to be seen within 181 – 270 days) - Moderate gross motor delays - Children that require assessment before school (Prep) - In-toeing causing tripping that is not asymmetrical (3 years and older) Examples: - 3-year-old: - Child cannot walk up and down stairs independently - Child unable to run and jump - Child with poor balance in walking (may have multiple falls) - Child unable to balance on one foot momentarily. Mild Motor Skill Delay (recommended to be seen within 365 days) - Mild gross motor delays (3 – 5 years of age) Examples: - 4-year-old: Not able to climb or use stairs confidently. - 5-year-old: - Unable to hop - Not able to use stairs confidently - Poorly coordinated ball skills